EXAMINING A CULTURALLY INFORMED MODEL OF MENTAL HEALTH CARE UTILIZATION AMONG LATINX COLLEGE STUDENTS

Abstract

Despite an elevated risk of mental health concerns among Latinx college students due to the unique stressors and challenges Latinx college students may face, including discrimination, cultural isolation, lack of representation, and low educational expectations, Latinx college students tend to underutilize mental health services. The behavioral model of health services utilization (BMHSU) has often been utilized to examine the individual characteristics that predispose individuals to use or not use health services, environmental factors that enable or impede health service use, and one’s need for health services as determined by symptoms, provider’s diagnoses, or other illness indicators. However, the BMHSU has been criticized for failing to consider the influence of specific cultural factors, and as such, may not fully account for disparities in mental health care utilization. The purpose of this study was to develop and examine a cultural adaptation of the BMHSU by including indicators of acculturation and related variables at each level (e.g., predisposing, enabling, and need factors) in hopes of creating a culturally informed model of mental health care utilization more applicable to Latinxs. The total sample was comprised of 126 Latinx undergraduate students, the majority of which were bilingual, second-generation immigrants of Catholic background. Results indicated that the culturally informed model of mental health care utilization more than doubled the predictive power of the BMHSU, accounting for 54% of the variance in utilization, whereas the traditional BMHSU only accounted for 24% of the variance in MHC utilization. Analysis of individual predictors revealed that mental health stigma and familism make help seeking behavior less likely. Meanwhile greater congruence between an individual’s perceived need for mental health care and a professional’s evaluation of need was found to promote help seeking behavior. Historically, cultural factors, including ethnic identity and familism, have been assumed to uniformly promote health and well-being among Latinxs, while acculturative stress and cultural beliefs such as machismo, have been associated with psychopathology. Findings of the current study emphasize the need to further understand the contexts in which cultural factors might be protective or function as a risk factor when tailoring research studies, and interventions that stem from such studies to Latinx populations.